Life-Course Circumstances and Frailty in Old Age Within Different European Welfare Regimes: A Longitudinal Study With SHARE

J Gerontol B Psychol Sci Soc Sci. 2020 Jun 2;75(6):1326-1335. doi: 10.1093/geronb/gbz140.

Abstract

Objectives: This study aimed to assess whether cumulative disadvantage in childhood misfortune and adult-life socioeconomic conditions influence the risk of frailty in old age and whether welfare regimes influence these associations.

Method: Data from 23,358 participants aged 50 years and older included in the longitudinal SHARE survey were used. Frailty was operationalized according to Fried's phenotype as presenting either weakness, shrinking, exhaustion, slowness, or low activity. Confounder-adjusted mixed-effects logistic regression models were used to analyze associations of childhood misfortune and life-course socioeconomic conditions with frailty.

Results: Childhood misfortune and poor adult-life socioeconomic conditions increased the odds of (pre-)frailty at older age. With aging, differences narrowed between categories of adverse childhood experiences (driven by Scandinavian welfare regime) and adverse childhood health experiences (driven by Eastern European welfare regime), but increased between categories of occupational position (driven by Bismarckian welfare regime).

Discussion: These findings suggest that childhood misfortune is linked to frailty in old age. Such a disadvantaged start in life does not seem to be compensated by a person's life-course socioeconomic trajectory, though certain types of welfare regimes affected this relationship. Apart from main occupational position, our findings do not support the cumulative dis/advantage theory, but rather show narrowing differences.

Keywords: Childhood disadvantage; Health outcomes; Socioeconomic status; Successful aging.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adverse Childhood Experiences* / economics
  • Adverse Childhood Experiences* / psychology
  • Adverse Childhood Experiences* / statistics & numerical data
  • Aged
  • Child Health
  • Employment
  • Europe / epidemiology
  • Female
  • Frailty* / diagnosis
  • Frailty* / epidemiology
  • Health Status Disparities
  • Humans
  • Life Change Events
  • Longitudinal Studies
  • Male
  • Quality of Life*
  • Social Welfare* / classification
  • Social Welfare* / statistics & numerical data
  • Socioeconomic Factors